The Experts below are selected from a list of 201 Experts worldwide ranked by ideXlab platform
Deschryver-kecskemeti K - One of the best experts on this subject based on the ideXlab platform.
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Small intestinal lesion resembling graft-vs-host disease. A case report in immunodeficiency and review of the literature.
Archives of pathology & laboratory medicine, 1991Co-Authors: Eun Y. Lee, Aliperti G, Deschryver-kecskemeti KAbstract:We report graft-vs-host disease-like histology in a small intestinal Biopsy specimen that was obtained from a patient with common variable immunodeficiency and related T-cell defect. We include findings from immunohistochemical studies and follow-up information. Review of the literature yielded only a small number of histologically documented cases of this lesion without previous bone marrow transplantation. Awareness of this clinicopathologic entity is important in the interpretation of Gastrointestinal Biopsy specimens.
Gregory Y Lauwers - One of the best experts on this subject based on the ideXlab platform.
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Gastrointestinal Biopsy findings of autoimmune enteropathy: a review of 25 cases
The American journal of surgical pathology, 2014Co-Authors: Ricard Masia, Gregory Y Lauwers, Stephen Peyton, Ian BrownAbstract:Autoimmune enteropathy (AIE) is a rare disorder characterized by severe diarrhea and small intestinal mucosal atrophy resulting from immune-mediated injury. It remains a challenging diagnosis because of its clinicopathologic variability. To better understand its histopathologic features, we describe the Gastrointestinal Biopsy findings of 25 patients, including children and adults. The most common finding on small intestinal Biopsy (13/25 cases, 52%) was villous blunting, expansion of the lamina propria by mixed but predominantly mononuclear inflammation, and neutrophilic cryptitis with or without crypt microabscesses. In 5 cases (20%), the duodenum exhibited changes indistinguishable from celiac disease, with villous blunting and intraepithelial lymphocytosis. Increased crypt apoptosis with minimal inflammation, resembling acute graft-versus-host disease, was observed in 4 cases (16%). The remaining 3 cases (12%) exhibited a mixture of 2 or more of the above patterns. Mucosal abnormalities outside the small intestine were present in all 24 cases with available biopsies (100%), with the stomach most commonly affected (19/22 cases, 86%), followed by the colon (14/22, 64%) and esophagus (5/18, 28%). Findings in non-small intestinal sites were variable and included mixed active and chronic inflammation, chronic inflammation alone, intraepithelial lymphocytosis, and increased apoptosis resembling acute graft-versus-host disease. In summary, AIE most commonly presents as an active enteritis with villous blunting and expansion of the lamina propria by mixed inflammation. Mucosal abnormalities are frequently seen elsewhere in the gut. AIE may thus be better regarded as a pan-Gastrointestinal autoimmune disorder, and biopsies from sites other than the small intestine may greatly facilitate its diagnosis.
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intraepithelial lymphocytosis in architecturally preserved proximal small intestinal mucosa an increasing diagnostic problem with a wide differential diagnosis
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Ian S Brown, Vikram Deshpande, Mari Minokenudson, Gregory Y LauwersAbstract:Abstract Context.—An increased intraepithelial lymphocyte density in an architecturally normal proximal small intestinal mucosal Biopsy is a common finding facing surgical pathologists dealing with Gastrointestinal Biopsy specimens. Approximately 1% to 2% of all proximal small intestinal biopsies will show this change. It is increasingly recognized by surgical pathologists that gluten-sensitive enteropathy is an important cause of this pattern; however, gluten-sensitive enteropathy accounts for the minority of all cases. A wide variety of immunologic stimuli can raise intraepithelial lymphocyte numbers. Among the other common associations are enteric infection, autoimmune disease, drugs, and gastric Helicobacter infection. Objective.—To outline the causes of intraepithelial lymphocytosis, to highlight the importance and the difficulties faced in establishing gluten-sensitive enteropathy as the cause, and to aid the surgical pathologist in the routine sign out of these cases. Data Sources.—A review of the ...
Bruce R Smoller - One of the best experts on this subject based on the ideXlab platform.
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intraepidermal bile pigment in skin Biopsy specimens for graft versus host disease versus erythema multiforme
Modern Pathology, 1998Co-Authors: B R Dilday, Bruce R SmollerAbstract:The differentiation of graft-verus-host disease (GVHD) from erythema multiforme (EM) presents a common diagnostic challenge in skin Biopsy specimens from patients who have received patients allogeneic bone marrow transplants. The presence of Gastrointestinal involvement might be the only way to make a diagnosis of GVHD in these cases. In the absence of liver function tests, Gastrointestinal Biopsy, or molecular techniques such as microsatellite DNA analysis, the presence of intraepidermal bile pigment might prove helpful in elucidating hyperbilirubinemia and allowing a pathologist to favor a diagnosis of GVHD over EM. Routinely processed archival tissue from 50 cases of GVHD (42 Caucasian and 8 of unknown race) and 50 cases of EM (31 Caucasian and 19 of unknown race) was examined for pigmentation. Intraepidermal pigmentation was stained for bile pigment and melanin. Among the intraepidermal EM lesions, 4 (8%) stained for intracorneal melanin, but none stained for bile pigment. Among the intraepidermal GVHD lesions, 8 (16%) stained for intracorneal melanin, but 3 (6%) stained for intracorneal bile pigment. In addition, 13 (26%) GVHD lesions and 9 (18%) EM lesions showed melanosis with melanin in all layers of the epidermis as well as within papillary dermal melanophages. Thus, when presented with a differential diagnosis of GVHD versus EM, the presence of intraepidermal bile pigment might suggest liver involvement and a diagnosis of GVHD.
Alberto M. Marchevsky - One of the best experts on this subject based on the ideXlab platform.
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Virtual microscopy and the Internet as telepathology consultation tools. A study of Gastrointestinal Biopsy specimens.
American journal of clinical pathology, 1999Co-Authors: Regina P.c. Singson, Sathima Natarajan, Joel K. Greenson, Alberto M. MarchevskyAbstract:Telepathology (TP) is the practice of pathology at a distance using videomicroscopy and telecommunication tools. We explore the use of "virtual microscopy" techniques and the Internet as tools for TP Gastrointestinal Biopsy consultations. Thirty-five Gastrointestinal Biopsy specimens were photographed in Los Angeles by using a high-resolution digital camera, a light microscope, and a Pentium 166 microcomputer. Several (2-8) digital photomicrographs were collected at 40x or 100x optical magnification, using 2,700 x 3,400 pixel resolution. The photomicrographs illustrated all the tissue fragments present in 1 of the Biopsy levels. They were saved in medium compression JPEG image format. These images can be magnified digitally up to 600% without visible degradation and scrolled at different magnifications on a video monitor, simulating examination under a light microscope. The images files (281 to 3,324 KB) were attached to e-mail messages containing patient information and sent through the Internet to Michigan for interpretation using a Power Macintosh 7100 system. The e-mail process was successful in 100% of instances; 2 files were corrupted owing to user error and had to be resent. Additional photos were requested in 1 case. In 33 of 35 cases, there was diagnostic concordance between the original and the TP diagnoses. The 2 discrepancies were due to diagnostic disagreement. This technology offers pathologists relatively inexpensive and effective tools for Gastrointestinal TP consultations.
Eun Y. Lee - One of the best experts on this subject based on the ideXlab platform.
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Small intestinal lesion resembling graft-vs-host disease. A case report in immunodeficiency and review of the literature.
Archives of pathology & laboratory medicine, 1991Co-Authors: Eun Y. Lee, Aliperti G, Deschryver-kecskemeti KAbstract:We report graft-vs-host disease-like histology in a small intestinal Biopsy specimen that was obtained from a patient with common variable immunodeficiency and related T-cell defect. We include findings from immunohistochemical studies and follow-up information. Review of the literature yielded only a small number of histologically documented cases of this lesion without previous bone marrow transplantation. Awareness of this clinicopathologic entity is important in the interpretation of Gastrointestinal Biopsy specimens.
